We aimed to report the response rate, side effects, and predictors of response and side effects from lasmiditan treatment in Korean patients with migraine.
We prospectively recruited patients who received lasmiditan at Seoul National University Hospital from April 2023 to March 2024. Patients' demographics, headache-specific variables, and previous treatment experience were collected at Visit1. We collected the treatment response and side effect profile. Maintenance, dose adjustment, and discontinuation were collected at Visit2, and we defined the tolerability as maintenance or dose increment. The univariable and multivariable logistic regression analysis was performed to identify predictors measured at Visit2.
154 patients were included in our study. At Visit1, 110(71.4%) and 44(28.6%) patients were prescribed lasmiditan 50mg and 100mg, respectively. At Visit2, treatment response was observed in 49(44.5%) patients receiving 50mg and 20(45.5%) patients receiving 100mg. 75(48.7%) patients reported side effects. Dizziness(N=45, 60.0%), somnolence(N=15, 20.0%), and nausea(N=13, 17.3%) were the most common side effects. The multivariable logistic model showed that female sex(HR 4.51, 95% CI 1.43–14.19, p=0.01) and higher dose(100mg vs. 50mg; HR 2.35, 95% CI 1.14–4.83, p=0.02) were independently associated with side effects. Lasmiditan dosage was adjusted as follows: dose escalation in 56(36.4%), dose reduction in 17(11.0%), and treatment discontinuation in 40(26.0%) patients. The remaining 41(26.6%) subjects maintained their initial dosage. Lasmiditan was well tolerated in 63.0%(97/154) of patients.
This is the first real-world data of lasmiditan response and side effects in Korean patients with migraine. Although used as low dose, lasmiditan was effective in approximately a half of patients in our study regardless of their demographics and headache characteristics. Dizziness was the most common side effects with a higher rate than that reported in clinical trials.